What Is the Best Practical Scheme for Initiating Oral Anticoagulant Treatment in Outpatients with Atrial Fibrillation?

Abstract

Patients with atrial fibrillation (AF) have an approximately four-fold increased risk of stroke and systemic embolism [1]. Generally thrombus forms in the left atrial appendage because of the relative inactivity of the atria during AF [2]. The risk of stroke exists in all patients with AF, but the incidence of stroke is related to coexistent cardiovascular disease, hypertension, diabetes, or previous stroke [3,4]. Advancing age is associated with increased stroke risk, probably due to the effect of left atrium enlargement and left ventricular diastolic dysfunction, frequently observed in elderly patients [5, 6], Nearly half of AF- associated strokes occur in patients older than 75 years.